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EL-15-1211 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FIL Phone: (305)795-2204 Fax: (305)756-8972 uv tJ Inspection Number: INSP-238700 Permit Number: EL-5-15-1211 Scheduled Inspection Date: July 10, 2015 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: SHOAF,JONATHAN Work Classification: Alteration Job Address: 103 NW 103 Street Miami Shores, FL 33150- Phone Number Parcel Number 1121360131580 Project: <NONE> Contractor: P&M ELECTRIC INC Phone: (305)949-6373 Building Department Comments INSTALL NEW CIRCUIT 20 AMP WIRE NEW GATE Infractio Passed Comments MOTOR INSPECTOR COMMENTS False Inspector Comments Passed E] Failed Correction ❑ Needed Re-inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 09, 2015 For Inspections please call: (305)762-4949 Page 31 of 35 t Part4Vx-12�11 `yt►ORES Miami Shores Village PW P1 e E. 1 li, IZeeidential le 10050 N.E.2nd Avenue NW nr€c�sst rcatf _ � � '••, ""' Miami Shores,FL 33138-0000 �� .;.: �. Phone: (305)7952204 fr P@fi1, iUhit3 � 1 :6/2)"015 Expiration: 11l29l201 Project Address Parcel Number Applicant _. ........ _._ �.. .._._._.. ....... _._ 103 NW 103 Street 1121360131580 Miami Shores, FL 33150- Block: Lot: JONATHAN SHOAF Owner Information Address Phone Cell JONATHAN SHOAF FL Contractor(s) Phone Cell Phone III LTotal P&M ELECTRIC INC 305 949-6373 on: $ 530 00 ( ) (305)588-9724q Feet: 0 Type of Work:INSTALL NEW CIRCUIT 20 AMP WIRE NEW Available Inspections: Additional Info: Inspection Type: Classification: Residential Review Electrical Scanning: 1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# EL-5-15-55652 DBPR Fee $2.25 06/02/2015 Check#: 10681 $ 109.10 $ 50.00 DCA Fee $2.25 Education Surcharge $0.20 05/21/2015 Check#: 10674 $50.00 $0.00 Permit Fee-Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $159.10 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL,WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate a d that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above- med cont r do a work stated. June 02, 2015 Authorized Signature:Owner / Applicantractor Agent ate Building Department Copnt / June 02,2015 1 R Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 MAY 2 1 2015 Tel: (305)795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 F BC 20 LO BUILDING Master Permit No. f LA<' ;-- 12A 1 \� PERMIT APPLICATION Sub Permit NOTVV 15 — 5"-'715 BUILDING Q ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL F-]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 103 nw 103 st City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-2136-013-1580 Is the Building Historically Designated:Yes NO Occupancy Type: _Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder):Jonathan Shoaf_ _Phone#:305 401-3545 Address:103 nw 103 st City: miami shores State: fl Zip: 33150 Tenant/Lessee Name: Phone#: _ Email: jonshoaf@gmaii.com CONTRACTOk: Company Name: P and M Electric Inc Phone#: 305 949-6373 Address: 1936 ne 148 st City: north miami State: fl Zip: 33181 Qualifier Name: S(�j Ti 7 f�r / Phone#: �°--1,3 _73' State Certification or Registration#: &L Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: _ City: State: Zip: Value of Work for this Permit:$ 3i�. Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ /Re lace Re air p p El Demolition Description of Work: /sem/� 160, ' 9. Specify color of color thru tile: Submittal Fee$ Permit Fee CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$_ Bond$ TOTAL FEE NOW DUE 1-D—Cl (Revised02/24/2014) Bonding Company's Name(if applicable) Bonding Company's Address _ City State Zip Mortgage Lender's Name(if applicable) D C4 I-qe Mortgage Lender's Address Po gN�r ( J City (0/t4 bv, u S State- (!)�/f CU Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS,TANKS, AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be pproved and a reinspection fee will be charged. Signature_ Signature ft OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of N CS 20 iJ� , by day of 20 �y K,-)CL- — ,w is personally known to �t )!f—T'7ib /^4ZJ79Qwho is personally known to me or who has produced as me or who has produced 4:— as identification and who did take an oath. identification and who did take an oath. NOTARY P L C: `\��` N16L.... TN/��i,� NOTARY PUBLIC: �JgS10s op�9F. rs , . Sign: Si �t EE13a1 o Print: # a Print: O Bond . � ,e• . Seal: i,�i�� I884CS�P��;�4`` Seal: gyp„ � Nota-Y Public State of �r Fio�ida v r° , Joanna iVl Felix,ano • o N1y Gornmission FF 082753 *1�12*Oi* **************** 1 Zm/s APPROVED BY �%/� /�((�Y Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)